PTOtherJournal of physical therapy science2021

Is the diaphragm thickness related to gait speed in patients with hemiplegia caused by cerebrovascular accident?

Takumi Jiroumaru, Michio Wachi, Shinichi Noguchi and 7 others

PMID 34177107

WHAT IT FOUND

In 11 community walkers after stroke, the unaffected to affected diaphragm thickness ratio during deep breath was linked to faster walking.

Other thickness measures were not. This does not show diaphragm training improves gait speed.

Key findings

01Gait speed was strongly and significantly correlated with the ratio of diaphragm thickness on the non-paretic side to the paretic side at maximal inhalation (r=0.892, p<0.05).

02Most other diaphragm thickness measures did not show a significant correlation with gait speed.

03Mean gait speed was 0.66 ± 0.26 m/s, and mean maximal inhalation diaphragm thickness ratio was 90.8 ± 9.0%.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Only 11 participants were studied, so the correlation could be unstable. All participants could walk without assistance, so it says little about people who need help to walk. Participants were long-term community residents, with mean period from onset 7.3 ± 4.5 years, so early post-stroke patients were not represented. The study measured diaphragm thickness, not activation, and did not assess other trunk muscles such as transverse abdominis, multifidus, or pelvic floor. The authors said larger interventional or longitudinal studies are needed, so this study cannot show that diaphragm thickness affects gait speed.

Declared interests

The study received no specific grant, and the authors declared no conflicts of interest.

The easy way to misread this

Do not read the r=0.892 correlation as proof that diaphragm thickness symmetry causes faster walking. Eleven people were measured, no training was tested, and most thickness measures were not related to gait speed.

Read it on PubMed →